The Maryland Emerging Infections Program (MD EIP) is a working partnership among Maryland's state health department (the Maryland Department of Health and Mental Hygiene), the Johns Hopkins University Bloomberg School of Public Health (JHSPH), and the University of Maryland, College Park (UMCP). Maryland became a national EIP network member site in 1997, and over the ensuing thirteen years, has developed into a mature partnership capable of performing active, laboratory-based surveillance using defined surveillance populations;conducting applied public health epidemiologic and laboratory activities;and implementing and evaluating pilot prevention and intervention projects. The MD EIP is also capable of rapidly responding to emerging infectious disease threats, as was demonstrated during the 2003-2004 and subsequent influenza seasons. Through this application, the MD EIP is requesting funding to support: (1) overall program infrastructure;(2) influenza epidemiology and laboratory capacity;and (3) surveillance for bloodstream infections among dialysis patients in out-patient settings. The first initiative will provide support for scientific leadership and further collaboration with the University of Maryland School of Public Health;provide training opportunities for program epidemiologists and informatics staff;fund a seminar to provide EIP surveillance and study findings to infection preventionists, clinical laboratorians, and local health department staff;and support other EIP infrastructure needs. The second initiative will provide the state public health laboratory with additional resources for conducting RT-PCR testing to confirm influenza infections during the upcoming seasons. In addition, the MD EIP will collaborate with CDC and the other EIP sites to develop a model that will provide interim estimates of the number of influenza cases, hospitalizations, and deaths as an influenza season unfolds. These activities will contribute to the DHMH influenza response program. The third initiative will complement the healthcare-associated infections (HAI) projects currently being conducted through the EIP and the Epidemiology and Laboratory Capacity (ELC) cooperative agreements. Dialysis patients are known to have high rates of bloodstream infections. This EIP project will develop capacity among dialysis centers to report data on bloodstream infections through the National Healthcare Safety Network (NHSN) dialysis module. This data will be used to develop prevention initiatives, assist the dialysis centers in meeting the CMS reporting requirements for the incidence of infection, and provide a model for other states to use in dialysis centers.